Ayers Campus Talent Search (ACTS)

Thank you for your interest in the Ayers Campus Talent Search Program (ACTS) at Gadsden State Community College. The ACTS Program is 100% federally funded through the U.S. Department of Education. The goal of ACTS is to increase the number of students who graduate high school, enroll in postsecondary education, and graduate from postsecondary education.

The ACTS program provides academic advising (such as college selection, financial aid information, scholarship information); personal advising (such as conflict resolution, anger management); college visits/cultural fieldtrips; and workshops.

Please read, detach, and retain the first two pages for future reference. If you have any questions, please feel free to contact our office at:

Gadsden State Community College Ayers Campus Talent Search

Room 101 1801 Coleman Road Anniston, AL 36207

Phone: (256) 832-1238 Email: ayersets@gadsdenstate.edu

: Ayers Campus Talent Search

Ayers Campus Talent Search Target Schools

High Schools Alexandria High School Anniston High School Cleburne County High School Ohatchee High School Oxford High School Piedmont High School Pleasant Valley High School Saks High School Weaver High School Wellborn High School White Plains High School

Middle Schools Anniston Middle School C.E. Hanna (6th grade)Oxford Middle SchoolPiedmont Middle School

Program Staff

Anika McGee, Director Veronica Fleming, Outreach Advisor Hope Rutherford, Outreach Advisor Denise Salter, Clerk amcgee@gadsdenstate.edu vfleming@gadsdenstate.edu vrutherford@gadsdenstate.edu dsalter@gadsdenstate.edu

Revised 4/20

Frequently Asked Questions

• Who is eligible to participate in the Ayers Campus Talent Search (ACTS) program?Students in grades 6 – 12 who meet the following criteria:

• Potential first generation college student (neither parent has earned a bachelor’s degree) and/or• Parent/guardian income consistent with federal guidelines and/or• Other as recommended by principal or counselor and slots are available• Enrolled at one of the 15 target schools (see front page)

Note: All ACTS participants must be U.S. citizens or verifiable permanent residents of the United States

• Are there additional qualifications/requirements?• Must have and maintain a GPA of 2.5 or higher• Must plan to enroll in post-secondary education after graduation• Must exhibit good behavior• Must have signed recommendation form by principal or counselor

• How much does it cost for my child to participate in this program?There is no cost to participate in ACTS, including fieldtrips and workshop materials provided.

• Is this program recruiting students for Gadsden State Community College?No. The ACTS program is not recruiting for GSCC or for any specific post-secondary institution.

• When and where will meetings with the participants take place?Meetings take place at the schools during the school day. Each school has set meeting times and designatedrooms/areas for participants to meet with their Outreach Advisor.

• Does this program provide scholarships?No. ACTS students are self-motivated and self-reliant. We only provide resources, information, and assistanceneeded to search for and secure scholarships on their own.

• Does my child have to reapply each year?No. Students remain in the program each year until high school graduation. A Participant Update Form isrequested each year for new addresses, phone numbers, email, social media or other needed information.

• What happens if I move to another school?Notify your new guidance counselor that you were a participant in another school. You may continue to receiveservices in your new school.

• Does my child need to have a special talent to be in this program?No. This program targets students who possess academic talent and are believed capable of pursuing rigorouscurriculum.

• Does this program offer tutoring?Yes. The ACTS program offers tutoring to participants through collaboration with their school. See your OutreachAdvisor for more information.

Ayers Campus Talent Search

Participant Application

School Name _______________________________________________ Current Grade____________________

Legal Name: ____________________________________________________________________________________

Mailing Address____________________________________________________________AL__________________

Street/PO Box City State Zip Code

Student Cell Phone___________________________ Student Home Phone______________________________

Student Email_____________________________________________ Gender: □ Male □ Female

Date of Birth__________/__________/__________ Age___________

Race/Ethnicity (Information is necessary for federal reporting requirements): Check one box

□ Hispanic or Latino

Circle one: Mexican Puerto Rican Cuban Central or South American Other Spanish Culture

□ Asian □ Black or African-American

□ White □ Native Hawaiian or Other Pacific Islander

□ American Indian or Alaska Native

□ Two or more races

Social Media Contact Info (Example: Facebook – John Doe or Twitter – Jane Doe or Instagram: JDaze)

Are you currently participating in other community outreach programs, such as Upward Bound? Please specify

_______________________________________________________________________________________________

Please help us learn more about you by answering the following questions:

1. What are your plans after graduating from high school?

□ Work □ Community College □ 4-year college

□ Military □ Trade/Vocational School □ Other_____________________________

2. What career(s) are you interested in? _____________________________________________________

3. Are you a dual enrollment/early college student (GSCC, JSU, etc.)? ____________________________________________________________________________________________________________________________

If accepted into the Ayers Campus Talent Search Program, I agree to meet with my ACTS Outreach Advisor regularly, attend a fieldtrip, maintain a GPA of 2.5 or higher, and prepare to enter post-secondary education after high school.

Student Signature_______________________________________________ Date_______________________

Please complete ENTIRE application. Incomplete applications will not be accepted.

Print clearly in BLUE or BLACK ink only.

First Middle Initial Last Prefer to be called

SECTION 1: STUDENT INFORMATION

Talent Search is 100% federally funded by the U.S. Department of Education

Revised 5/20

PARENT/FAMILY INFORMATION

Please PRINT name(s) of whom student lives with:

□ Father_____________________________________ □ Mother_____________________________________

□ Stepfather__________________________________ □ Stepmother__________________________________

□ Legal Guardian(s) ______________________________ □ Foster Parent(s) ______________________________

□ Other___________________________________________ _________________________________________

CONFIDENTIAL

FINANCIAL INFORMATION

The Talent Search Program is 100% funded by the U.S. Department of Education and it requires information related

to household income level and parent educational background.

The information provided will be used to determine student eligibility to participate in the ACTS Program.

Does either parent/guardian have a high school diploma? □ Yes □ No

Does either parent/guardian listed above have a four-year college degree? □ Yes □ No

Does your child qualify for free or reduced lunch? □ Yes □ No

Total number of people in household, including yourself (circle one) 1 2 3 4 5 6 7 8 9 10+

What was your household’s taxable income last year? (NOTE: Not gross or net income—indicate range below with a

check mark “ ”)

____Zero taxable income

____$1 - $19,140____$19,141 - $25,860____$25,861 - $32,580

STUDENT CITIZENSHIP STATUS: (Check one)

□ U.S. Citizen

□ Permanent Resident (Please provide ARN for STUDENT below)

Student Alien Registration Number (ARN) ________________________________________

____$32,581 - $39,300____$39,301 - $46,020____$46,021 - $52,740

____$52,741 - $59,460____$59,461 - $66,180____$66,181 or above

STUDENT NEEDS ASSESSEMENT

Please check ACTS services your child may need and/or want: (Check all that apply)

□ Tutoring □ Study Skills □ Financial Literacy□ Academic Advising □ Cultural Awareness & Diversity □ Self-Awareness□ ACT/SAT Prep □ Decision Making □ Why College?□ Scholarship Information □ Internet Safety/Social Media□ FAFSA/Financial Aid Info □ Interviewing Skills□ College Visits □ Job Shadowing/Mentoring□ College Admissions Assistance □ Other___________________________________________□ Career Exploration

Parent/Guardian Signature_________________________________________ Date____________________

SECTION 2: STUDENT ELIGIBILITY INFORMATION

(To be completed by PARENT OR GUARDIAN ONLY)

Revised 3/20

The “Release of Records” is required for program participation. Records will be used to assess student needs, monitor

progress, document eligibility and for reporting purposes. This information is confidential and protected under The Family

and Education Rights and Privacy Act (FERPA). ACTS will not release any confidential information without your written

consent.

Please certify authorizations and release:

I hereby grant permission to the Ayers Campus Talent Search program for access to the educational records of:

(Name of Student) ________________________________________________

including (but not limited to) grades, test scores, free/reduced price lunch eligibility, class schedules, attendance

and behavior reports for the duration of the student’s enrollment in the ACTS Program.

I authorize the postsecondary institution that my child attends to release to the Ayers Campus Talent Search

program admissions information, proof of enrollment, and scholarship award information.

I authorize the use of my child’s photograph by the Ayers Campus Talent Search program for editorial and/or

advertising purposes, social media, recruitment, newsletters, brochures, workshops, and instructional videos for

the duration of the student’s involvement in the ACTS program.

I certify that the information in this application is complete and true to the best of my knowledge.

X__________________________________________________ ________________________

Parent/Guardian Signature Date

Parent Printed Name__________________________________________________________________

Mailing Address_____________________________________________________AL__________________________ Street/PO Box City State Zip Code

Cell Phone ______________________________________ Home Phone ___________________________________

Work Phone _____________________________________ Alternate Phone___________________________________

Email Address ________________________________________________________________

The best way to contact me is: □ Home Phone □ Work Phone □ Cell Phone □ Email □ U.S. Mail

Please list alternative contact information (such as other parent, grandparents, adult siblings, etc.):

Contact Name & Relationship_________________________________________ Phone___________________________

Contact Name & Relationship_________________________________________ Phone___________________________

Please provide any further information the ACTS program may need about this student (gifted, disability, parent, etc.):

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Revised 5/20

SECTION 3: PARENT/GUARDIAN AUTHORIZATION & RECORD/MEDIA RELEASE

Email completed application to: ayersets@gadsdenstate.edu